Efficacy of Gene Polymorphism in Predicting the Dosage of Sufentanil After Laparoscopic Surgery
Objective To investigate the value of gene polymorphism in early assessment of dosage of sufentanil in patients after laparoscopic surgery.Methods The clinical data of patients underwent laparoscopic surgery in the perioperative period admitted to the hospital from April 2021 to March 2023 were collected.Before surgery,the single nucleotide polymorphism(SNP)of genes CYP3A4(rs2242480),COMT(rs4680),OPRM1(rs1799971)and ABCB1(rs1045642)were detected by the real-time fluorescence quantitative polymerase chain reaction;after surgery,the intravenous patient-controlled analgesia(Sufentanil Citrate Injection + Tropisetron Hydrochloride Injection)was given,and the dosage of sufentanil used by the patients 24 h after surgery was recorded.The relevant factors affecting the dosage of sufentanil after laparoscopic surgery were evaluated by the ordinal Logistic regression analysis.The alignment diagram model based on the independent relevant factors was constructed by the R software,the calibration curve and receiver operating characteristic(ROC)curve were drawn to evaluate the early predictive value of the model.Results A total of 300 patients were included,the median postoperative dosage of sufentanil was 30.35 μg.The patients were divided into the group A(total dosage≤25%),the group B(total dosage was in the range of 26%to 50%),the group C(total dosage was in the range of 51%to 74%)and the group D(total dosage≥75%)based on the the quartile interval of total dosage,with 75 cases in each group.The surgical time,preoperative fasting blood glucose(FBG)level,and the genotype proportions of CYP3A4(rs2242480),ABCB1(rs1045642),COMT(rs4680)and OPRM1(rs1799971)in the four groups were significantly different(P<0.05).The ordinal Logistic regression analysis showed that the surgical time,preoperative FBG level and CT genotype of CYP3A4(rs2242480)were the independent influencing factors of sufentanil dosage after laparoscopic surgery(P<0.05).The C-index of the alignment diagram model for early prediction of postoperative sufentanil dosage was 0.915,and the calibration curve of the model was similar to the ideal curve.The ROC curve analysis showed that the alignment diagram model had an area under the drug-time curve of 0.909,a sensitivity of 82.67%and a specificity of 86.67%in the early assessment of sufentanil dosage.Conclusion The SNP of CYP3A4(rs2242480)is an independent influencing factor on the dosage of sufentanil after laparoscopic surgery.Preoperative detection of the SNP of CYP3A4(rs2242480)in patients is helpful to guide the clinical individualized use of sufentanil for analgesia.
国家科技期刊平台
NSTL
万方数据
维普
